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Drug Interactions between Hyolev MB and Limbitrol DS

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

amitriptyline methylene blue

Applies to: Limbitrol DS (amitriptyline / chlordiazepoxide) and Hyolev MB (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

If you are currently being treated with amitriptyline, let your doctor know before you receive methylene blue. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. Depending on your condition, your doctor may want you to discontinue amitriptyline for at least two weeks before you start treatment with methylene blue, or prescribe an alternative medication. Otherwise, you will need to be closely monitored by your doctor during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Major

sodium biphosphate phenyl salicylate

Applies to: Hyolev MB (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate) and Hyolev MB (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

The following interaction applies only to products containing sodium biphosphate that are used for bowel cleansing. It does not apply to products containing sodium biphosphate that are used for other, non-laxative related purposes.

Bowel cleansing with sodium biphosphate can cause kidney failure, in some cases up to several months after the procedure. Although it rarely occurs, the risk is increased in individuals receiving treatment with phenyl salicylate, especially if they are also elderly or frail. You may need a dose adjustment or special tests to safely use both medications. Combining these medications may also increase the risk of dehydration and electrolyte abnormalities. In severe cases, dehydration and electrolyte abnormalities can lead to irregular heart rhythm, seizures, and kidney problems. You should use sodium biphosphate exactly as prescribed by your doctor, and drink plenty of clear fluids before, during, and after the cleansing process to keep yourself hydrated. Your doctor may also recommend an electrolyte rehydration solution that you can use. Talk to your doctor if you have any concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

amitriptyline chlordiazePOXIDE

Applies to: Limbitrol DS (amitriptyline / chlordiazepoxide) and Limbitrol DS (amitriptyline / chlordiazepoxide)

Using amitriptyline together with chlordiazePOXIDE may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

amitriptyline hyoscyamine

Applies to: Limbitrol DS (amitriptyline / chlordiazepoxide) and Hyolev MB (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

Using amitriptyline together with hyoscyamine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

amitriptyline sodium biphosphate

Applies to: Limbitrol DS (amitriptyline / chlordiazepoxide) and Hyolev MB (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

The following interaction applies only to products containing sodium biphosphate that are used for bowel cleansing. It does not apply to products containing sodium biphosphate that are used for other, non-laxative related purposes.

amitriptyline can cause seizures and an irregular heart rhythm that may be serious and potentially life-threatening, although these are relatively rare side effects. The risk is increased if you have low blood levels of electrolytes such as calcium, magnesium, potassium or sodium, which can occur with bowel cleansing preparations or excessive use of medications that have a laxative effect. You should use sodium biphosphate exactly as prescribed by your doctor, and drink plenty of clear liquids before, during, and after the cleansing process to avoid becoming dehydrated. Your doctor may be able to recommend specific fluids you can drink before starting sodium biphosphate to help maintain your electrolyte levels. He/she may also want to monitor your electrolyte levels and/or heart rhythm. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications. In addition, you should let your doctor know if you experience signs and symptoms of low electrolyte levels such as weakness, tiredness, drowsiness, dizziness, confusion, tingling, numbness, muscle pain, cramps, nausea, or vomiting. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Moderate

chlordiazePOXIDE food

Applies to: Limbitrol DS (amitriptyline / chlordiazepoxide)

Alcohol can increase the nervous system side effects of chlordiazePOXIDE such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with chlordiazePOXIDE. Do not use more than the recommended dose of chlordiazePOXIDE, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

sodium biphosphate food

Applies to: Hyolev MB (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

Oral medications may not be properly absorbed when they are taken within one hour before starting sodium biphosphate for bowel cleansing. Talk to your doctor or pharmacist to see if you should adjust the dosing schedule of your other medications before you begin bowel cleansing treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

amitriptyline food

Applies to: Limbitrol DS (amitriptyline / chlordiazepoxide)

Ask your doctor before using amitriptyline together with ethanol, this can alter the effects of amitriptyline and cause increased side effects. Call the doctor if you experience uneven heartbeats, extreme drowsiness, confusion, agitation, vomiting, blurred vision, sweating, muscle stiffness, feeling light-headed, and seizures. You should be warned not to exceed recommended dosages, to avoid alcohol, and to avoid activities requiring mental alertness. If your doctor prescribes these medications together, you may need a dose adjustment to safely take this combination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

hyoscyamine food

Applies to: Hyolev MB (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

Ask your doctor before using hyoscyamine together with ethanol. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking hyoscyamine. You should be warned not to exceed recommended dosages and to avoid activities requiring mental alertness. If your doctor prescribes these medications together, you may need a dose adjustment to safely take this combination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.